0001567619-22-019012.txt : 20221101
0001567619-22-019012.hdr.sgml : 20221101
20221101162315
ACCESSION NUMBER: 0001567619-22-019012
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20221028
FILED AS OF DATE: 20221101
DATE AS OF CHANGE: 20221101
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Casey Ted
CENTRAL INDEX KEY: 0001856959
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38785
FILM NUMBER: 221350553
MAIL ADDRESS:
STREET 1: 5801 TENNYSON PKWY SUITE 275
CITY: PLANO
STATE: TX
ZIP: 75024
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: STRYVE FOODS, INC.
CENTRAL INDEX KEY: 0001691936
STANDARD INDUSTRIAL CLASSIFICATION: FOOD & KINDRED PRODUCTS [2000]
IRS NUMBER: 871760117
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5801 TENNYSON PARKWAY
STREET 2: SUITE 275
CITY: PLANO
STATE: TX
ZIP: 75024
BUSINESS PHONE: 646-565-3861
MAIL ADDRESS:
STREET 1: 5801 TENNYSON PARKWAY
STREET 2: SUITE 275
CITY: PLANO
STATE: TX
ZIP: 75024
FORMER COMPANY:
FORMER CONFORMED NAME: Andina Acquisition Corp. III
DATE OF NAME CHANGE: 20161208
4
1
doc1.xml
FORM 4
X0306
4
2022-10-28
0
0001691936
STRYVE FOODS, INC.
SNAX
0001856959
Casey Ted
C/O STRYVE FOODS, INC.
5801 TENNYSON PARKWAY, SUITE 275
PLANO
TX
75024
1
0
0
0
Class A Common Stock
2022-10-28
4
A
0
17766
0
A
277817
D
Class A Common Stock
388306
I
See Footnote
Class V Common Stock
1491314
D
Class B Units
0
Class A Common Stock
1491314
1491314
D
Represents director's fees paid in restricted stock from the Issuer's Omnibus Incentive Plan.
One-half of the securities are owned by the TRC GST TRFBO Trinity Jennifer Wommack Casey BTD 09302011 and the other half are owned by TRC GST TRFBO Avery Maryanna Wommack Casey BTD 09302011. Thomas Farrell Casey is the trustee and control person of, with voting and dispositive power over the securities held by, such trusts. The reporting person disclaims beneficial ownership of the securities owned by the trusts.
Subject to the terms of an Exchange Agreement with Stryve Foods, Inc. ("Stryve"), a set of one Class B Unit and one share of Class V Common Stock is exchangeable for one share of Class A Common Stock of Stryve after the expiration of a lock-up applicable to such securities. The Class V Common Stock provides the holder with voting rights, but not economic rights, with respect to Stryve.
/s/ Ted Casey by John J. Wolfel, Attorney-in-Fact
2022-11-01